Over the past 24 hours, reports of several outbreaks of Monkeypox have been coming out of the DRC (although their Health Ministry site makes no mention of it), including 51 recent cases in Bas-Uéle (350 km from the CAR outbreak).

While small monkeypox outbreaks are not unusual in central Africa (the DRC reported 20 cases in September 2015), today's report suggests a much larger, and wider spread outbreak. Reportedly nearly 200 cases have emerged in the past few weeks.

The outbreak of monkeypox, a viral
disease similar to smallpox surfaced in Aketi territory of the province
of Bas-Uélé, where 51 new cases were recorded in the first week of
February current.

Also known as monkey pox, the disease has already killed
two people, alerted Tuesday, February 9 aware of the area Medical
Officer Aketi, Dr Innocent Akonda. In the process,
he says that thirteen cases are diagnosed in the Bombongolo health
area, fifteen in that of Aboso and twenty-one other in the twelve other
health areas of the territory.

According to several local sources, the situation is alarming and requires immediate intervention. With the new cases, the health area is already 195 cases including 8 deaths, said Dr. Innocent Akonda.

For Dr. Innocent Akonda, this highly contagious disease
spread in the Aketi health area because of several difficulties that do
not facilitate the fight against the monkeypox virus.

These difficulties became almost a brake for better
medical care to the population, he has cited the lack of qualified
medical personnel and lack of adequate sanitation.

Monkeypox is a rare virus, endemic in monkeys and rodents in central Africa, that produces a remarkably `smallpox looking' illness in humans. although not as deadly. Human monkeypox was first identified
in 1970 in the DRC, and since then has sparked small, sporadic
outbreaks in the Congo Basin and Western Africa.

The name `monkeypox’ is a bit of a misnomer. It was first detected
(in 1958) in laboratory monkeys, but further research has revealed its
host to be rodents or possibly squirrels.

Humans can contract it in the wild from an animal bite or direct contact with the infected animal’s blood, body fluids, or lesions, but consumption
of undercooked bushmeat is also suspected as an infection risk.

The
disease also can be spread from person to person, but it is much less
infectious than smallpox. The virus is thought to be transmitted by
large respiratory droplets during direct and prolonged face-to-face
contact. In addition, monkeypox can be spread by direct contact with
body fluids of an infected person or with virus-contaminated objects,
such as bedding or clothing.

According to the CDCthere
are two distinct genetic groups (clades) of monkeypox virus—Central
African and West African. West African monkeypox is associated with
milder disease, fewer deaths, and limited human-to-human transmission.

In 1996-97, an unusually large outbreak occurred in the Democratic Republic of Congo (see Eurosurveillance Report), infecting more than 500 in the Katako-Kombe and Lodja regions. Mortality rates
were lower for this outbreak (1.5%) than earlier ones, but this was the
biggest, and longest duration outbreak on record.

Somewhat famously, in 2003 the United States saw an outbreak (of the milder, West African clade)
that affected 47 confirmed and probable cases across
six states—Illinois, Indiana, Kansas, Missouri, Ohio, and Wisconsin -
all of whom had contact with infected prairie dogs purchased as pets.

These pets became infected when an animal distributor imported hundreds of small animals from
Ghana, which in turn infected prairie dogs that were subsequently sold
to the public (see MMWRUpdate On Monkeypox 2003).

While still considered a geographically limited threat, in 2010 a study that appeared in PNAS warned that the incidence of human monkeypox
infection was increasing, and that it posed a potential risk well beyond
localized outbreaks in Africa.

Given the size, and quick spread of this latest outbreak, we'll continue to check in on it in the days and weeks ahead.